Individual
HALIE MICHELE TACKITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(972) 213-5923
Mailing address
4061 BLACKCHAMP RD, MIDLOTHIAN, TX 76065-5748
(972) 213-5923
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
901249
TX
Other
Enumeration date
05/06/2024
Last updated
06/21/2024
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